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(SDAS) Asthma, Health Disparities and Developmental Pediatrics
Project Number: R40 MC 11268-01
Grantee: University of Virginia
Department/Center: School of Medicine
Project Date: 2/1/2009
James Blackman, MD
Professor of Pediatrics
2270 Ivy Road
Charlottesville, VA 22903
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
- Early Childhood (3-5 years)
- Middle Childhood (6-11 years)
- Adolescence (12-18 years)
Asthma is the most common chronic disease among children. High rates of developmental and behavioral problems accompany asthma and are related to severity. The goal of this study is to improve the comprehensive health of children with asthma by examining how health disparities risk factors, such as poverty, limited access to healthcare, lack of health insurance, family dysfunction, and socioeconomic disadvantage, may exacerbate developmental and behavioral co-morbidities. We will utilize the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) for this study. This research addresses two of MCHB's strategic research issues: # II, elimination of health disparity barriers for MCH populations, and # IV, promotion of healthy development of MCH populations. Asthma has been a major focus of MCH investments and programs. Aim 1 of the study is to verify the high rates of developmental and behavioral comorbidities among children with asthma and compare these rates to those of children with other chronic diseases and to those without special health care needs. We hypothesize that children with asthma have significantly higher rates of developmental and behavioral problems than children with other chronic illnesses or children without special health care needs. Aim 2 of the study is to examine the impact of health disparities risk factors (poverty, limited access to healthcare, lack of health insurance, family dysfunction, and socioeconomic disadvantage) on the rates of developmental and behavioral co-morbidities among children with asthma. We hypothesize that risk factors for health disparities increase the rates of developmental and behavioral co-morbidities among children with asthma. Aim 3 of the study is to determine the role of race/ethnicity on rates of developmental and behavioral problems independent of risk factors for health disparities. We hypothesize that race/ethnicity does not impact rates of developmental and behavioral problems among children with asthma when poverty, lack of health insurance, poor access to care, non-English speaking status, and family stability are taken into account. For all aims of the study, we plan on using logistic regression to model the odds of the various developmental and behavioral outcomes available in the NS-CSHCN taking advantage of the complex survey design that allows for inference on the nation's population of children. Sophisticated statistical and epidemiologic techniques will be used to assess various confounding and effect-modifying relationships of interest, which will also allow for more accurate inference related to the aims themselves. A better understanding of the interaction of health disparity risk factors and asthma on development and behavior will prompt more narrowly targeted intervention programs.
Listed is descending order by year published.
Blackman JA, Gurka MJ, Gurka KK, Oliver MN. Emotional, developmental and behavioural co-morbidities of children with chronic health conditions. J Pediatrics and Child Health. 2011 Oct;47(10):742-7.
Asthma, Health Disparities, Social & Emotional Development, Access to Health Care, Chronic Illness, Special Health Care Needs, Insurance Coverage